Objective:Single-use flexible ureteroscopes(fURSs)have recently been introduced by different companies.Goal of this in-vitro study was to compare four fURSs.Methods:We performed in vitro analysis of Uscope 7.5 Fr and ...Objective:Single-use flexible ureteroscopes(fURSs)have recently been introduced by different companies.Goal of this in-vitro study was to compare four fURSs.Methods:We performed in vitro analysis of Uscope 7.5 Fr and Uscope 9.5 Fr(Pusen Ltd.,Zhuhai,China),LithoVue 9.5 Fr(LithoVue,Boston Scientific,MA,USA),and Indoscope 9.5 Fr(Bioradmedisys,Pune,India).Optical characteristics(image resolution,color representation,and luminosity)were compared at various distances of 10 mm,20 mm,and 50 mm.Deflection and irrigation were evaluated with and without accessories.Results:Color perception was comparable for all scopes at 10 mm(p<0.05),while Lithovue 9.5 Fr was comparable with Indoscope 9.5 Fr at the distances of 20 mm and 50 mm.Both scopes were statistically better than both Uscopes at the distances of 20 mm and 50 mm.Image resolution powers were comparable amongst all fURSs at the distances of 10 mm and 20 mm(3.56 line pairs per millimeter[lp/mm]).However,Indoscope(3.56 lp/mm)was superior to LithoVue and Uscope scopes(3.17 lp/mm)at the distance of 50 mm.Luminosity at the distance of 10 mm was comparable for LithoVue and Uscope 9.5 Fr.However,at the distances of 20 mm and 50 mm,LithoVue had the highest luminosity while Uscope 7.5 Fr had the lowest one.Indoscope had lower luminosity than other 9.5 Fr scopes at all distances.With empty working channel and 200 mm laser fiber,Indoscope had the maximum deflection(285).With basket,Uscope 7.5 Fr had the maximum loss of deflection(30)while Indoscope had no deflection loss.With empty working channel,all scopes had comparable irrigation flow rates in both deflected and undeflected state.Similarly,with 200 mm laser or basket,irrigation flow rates were comparable in all scopes.Conclusion:Color representation was equivalent for Indoscope and LithoVue,while being better than Uscope 7.5 Fr and Uscope 9.5 Fr.Image resolution was comparable in all scopes at the distances of 10 mm and 20 mm.Beyond the distance of 10 mm,luminosity of LithoVue was the highest and that of Uscope 7.5 Fr was the lowest.Deflection loss was the minimum with Indoscope and the maximum with 7.5 Fr Uscope.Under all scenarios,irrigation flow rates were comparable in all scopes.展开更多
Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symp...Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.展开更多
Background： Percutaneous nephrolithotomy （PCNL） is the most widely recommended treatment lbr calyceal diverticular calculi, providing excellent stone-free results. However, its invasiveness is not negligible consid...Background： Percutaneous nephrolithotomy （PCNL） is the most widely recommended treatment lbr calyceal diverticular calculi, providing excellent stone-free results. However, its invasiveness is not negligible considering its major complication rates. Flexible ureteroscopy （FURS） is currently used to treat calyceal diverticula. However, the greatest drawback of FURS is locating the diverticulum since its neck is narrow and concealed. In such a case, the FURS procedure must be converted to PCNL. The aim of this study was to evaluate ultrasound-guided flexible ureteroscopy （UFURS） identifying diverticulum and the managenlent of calyceal diverticular calculi. Methods： A retrospective analysis was conducted on 24 patients who had calyceal diverticnlar calculi. In all 12 patients in tile UFURS group, direct FURS failed to find evidence of calyceal diverticula but were confirmed with imaging. The other 12 patients in the PCNL group received PCNL plus fulguration of the divenicular walls. Results： Puncture ofcalyceal diverticulum was successful in all 12 UFURS patients. Two patients in this group had postoperative residual calculi and two patients developed lever. In the PCNL group, percutaneous renal access and lithotomy were successful in all 12 patients. One patient in this group had residual calculi, one had perirenal hematoma, and two patients developed fever. No significant difference was found in the operating time （UFURS vs. PCNL, 91.8 ± 24.2 vs. 86.3 ± 18.7 min）, stone-free rate （UFURS vs. PCNL, 9/12 vs. 10/12）, and rate of successful lithotripsy （UFURS vs. PCNL, 10/12 vs. 11/12） between the two groups （all P 〉 0.05）. Postoperative pain scores in the FURS group were significantly lower than that in the PCNL group （2.7 ±1.2 vs. 6.2 ±1.5. P 〈 0.05）. Hospital stay in the UFURS group was significantly shorter than that in the PCNL group （3.4 ± 0.8 vs. 5.4 ± 1.0 days, P 〈 0.05）. All patients were symptom-free following surgery （UFURS vs. PCNL, 10/10 vs. 12/12）. Conclusion： Ultrasound-guided puncture facilitates identification of calyceal diverticula during FURS and improves the success rate of FURS surgery.展开更多
文摘Objective:Single-use flexible ureteroscopes(fURSs)have recently been introduced by different companies.Goal of this in-vitro study was to compare four fURSs.Methods:We performed in vitro analysis of Uscope 7.5 Fr and Uscope 9.5 Fr(Pusen Ltd.,Zhuhai,China),LithoVue 9.5 Fr(LithoVue,Boston Scientific,MA,USA),and Indoscope 9.5 Fr(Bioradmedisys,Pune,India).Optical characteristics(image resolution,color representation,and luminosity)were compared at various distances of 10 mm,20 mm,and 50 mm.Deflection and irrigation were evaluated with and without accessories.Results:Color perception was comparable for all scopes at 10 mm(p<0.05),while Lithovue 9.5 Fr was comparable with Indoscope 9.5 Fr at the distances of 20 mm and 50 mm.Both scopes were statistically better than both Uscopes at the distances of 20 mm and 50 mm.Image resolution powers were comparable amongst all fURSs at the distances of 10 mm and 20 mm(3.56 line pairs per millimeter[lp/mm]).However,Indoscope(3.56 lp/mm)was superior to LithoVue and Uscope scopes(3.17 lp/mm)at the distance of 50 mm.Luminosity at the distance of 10 mm was comparable for LithoVue and Uscope 9.5 Fr.However,at the distances of 20 mm and 50 mm,LithoVue had the highest luminosity while Uscope 7.5 Fr had the lowest one.Indoscope had lower luminosity than other 9.5 Fr scopes at all distances.With empty working channel and 200 mm laser fiber,Indoscope had the maximum deflection(285).With basket,Uscope 7.5 Fr had the maximum loss of deflection(30)while Indoscope had no deflection loss.With empty working channel,all scopes had comparable irrigation flow rates in both deflected and undeflected state.Similarly,with 200 mm laser or basket,irrigation flow rates were comparable in all scopes.Conclusion:Color representation was equivalent for Indoscope and LithoVue,while being better than Uscope 7.5 Fr and Uscope 9.5 Fr.Image resolution was comparable in all scopes at the distances of 10 mm and 20 mm.Beyond the distance of 10 mm,luminosity of LithoVue was the highest and that of Uscope 7.5 Fr was the lowest.Deflection loss was the minimum with Indoscope and the maximum with 7.5 Fr Uscope.Under all scenarios,irrigation flow rates were comparable in all scopes.
文摘Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.
文摘Background： Percutaneous nephrolithotomy （PCNL） is the most widely recommended treatment lbr calyceal diverticular calculi, providing excellent stone-free results. However, its invasiveness is not negligible considering its major complication rates. Flexible ureteroscopy （FURS） is currently used to treat calyceal diverticula. However, the greatest drawback of FURS is locating the diverticulum since its neck is narrow and concealed. In such a case, the FURS procedure must be converted to PCNL. The aim of this study was to evaluate ultrasound-guided flexible ureteroscopy （UFURS） identifying diverticulum and the managenlent of calyceal diverticular calculi. Methods： A retrospective analysis was conducted on 24 patients who had calyceal diverticnlar calculi. In all 12 patients in tile UFURS group, direct FURS failed to find evidence of calyceal diverticula but were confirmed with imaging. The other 12 patients in the PCNL group received PCNL plus fulguration of the divenicular walls. Results： Puncture ofcalyceal diverticulum was successful in all 12 UFURS patients. Two patients in this group had postoperative residual calculi and two patients developed lever. In the PCNL group, percutaneous renal access and lithotomy were successful in all 12 patients. One patient in this group had residual calculi, one had perirenal hematoma, and two patients developed fever. No significant difference was found in the operating time （UFURS vs. PCNL, 91.8 ± 24.2 vs. 86.3 ± 18.7 min）, stone-free rate （UFURS vs. PCNL, 9/12 vs. 10/12）, and rate of successful lithotripsy （UFURS vs. PCNL, 10/12 vs. 11/12） between the two groups （all P 〉 0.05）. Postoperative pain scores in the FURS group were significantly lower than that in the PCNL group （2.7 ±1.2 vs. 6.2 ±1.5. P 〈 0.05）. Hospital stay in the UFURS group was significantly shorter than that in the PCNL group （3.4 ± 0.8 vs. 5.4 ± 1.0 days, P 〈 0.05）. All patients were symptom-free following surgery （UFURS vs. PCNL, 10/10 vs. 12/12）. Conclusion： Ultrasound-guided puncture facilitates identification of calyceal diverticula during FURS and improves the success rate of FURS surgery.
